Until better prevention methods are available

Until better prevention methods are available, the only way to ensure freedom from the risk of HIV infection, for many people, is to forgo sex. In some populations in low- and middle-income countries, the median number of sexual partners newly-diagnosed women have had is one, and getting married is an HIV risk factor. Condoms are unavailable to many people and in many locations. In any case, condoms cannot be used by couples trying to conceive and their use within marriage and long-term primary relationships is the exception rather than the rule (see Condoms and lubricants for these data).
However, it is extremely difficult to keep questions of sexual morality, sexual stigma and discrimination against women and sexual minorities out of the debate. The benefits of abstinence and fidelity have become entangled with the virtues of marriage, and it has been hard to separate personal choices from dominant cultural norms. The promotion of condoms has been portrayed as the promotion of promiscuity. Conversely, and in reaction to the perceived morality of the majority, ‘great sex’ has sometimes been portrayed as a right and a good thing in itself; suggesting or influencing people to delay or restrict it has been seen as oppressive.
Abstinence?only programs are widespread and well?funded, particularly in the United States and countries supported by the US President’s Emergency Plan for AIDS Relief. On the premise that sexual abstinence is the best and only way to prevent HIV, abstinence?only interventions aim to prevent, stop, or decrease sexual activity. These programs differ from abstinence?plus designs: abstinence?plus programs promote safer?sex strategies (e.g., condom use) along with sexual abstinence, but abstinence?only programs do not, and instead often highlight the limitations of condom use. An up?to?date review suggests that abstinence?only programs do not affect HIV risk in low?income countries; this review examined the evidence in high?income countries.
Abstinence, be faithful, use a condom, also known as the ABC strategy or abstinence-plus sex education, also known as abstinence-based sex education, is a sex education policy based on a combination of “risk avoidance” and harm reduction which modifies the approach of abstinence-only sex education by including education about the value of partner reduction safe sex and birth control methods. Abstinence-only sex education is strictly to promote the sexual abstinence until marriage, and does not teach about safe sex or contraceptives. The abstinence-based sex education program is meant to stress abstinence and include information on safe sex practices. In general terms, this strategy of sex education is a compromise between abstinence-only education and comprehensive sex education.
Correct and consistent condom use
Consistent and correct condom use provides a high level of protection against bacterial sexually transmitted infections (STIs), US investigators report in Sexually Transmitted Infections. Individuals who always used condoms correctly were almost 60% less likely to be diagnosed with an infection. Consistent condom use on its own did not reduce the risk of bacterial STIs. “Efforts to promote condom use should be augmented with efforts to promote their correct use,” write the authors. “Condom use errors and problems are a global issue. Incomplete use of condoms is a problem requiring targeted education. Rectifying issues such as poor fit and feel of condoms and using oil-based lubricants may substantially reduce slippage and breakage. “Condoms are a cornerstone of HIV prevention and sexual health campaigns. A number of well-designed studies have shown their protective effect against male-to-female transmission of herpes, chlamydia, gonorrhea, syphilis and human papillomavirus (HPV). However, whether condoms provide protection against the acquisition of STIs remains controversial. Research looking at this question has had number of important limitations. The most important of these is a failure to adjust for incorrect use of condoms (not using condoms from the start to the finish of penetrative sex) or condom ‘accidents’ such as slippage and breakage.
Delay of sexual debut
Delay of sexual debut is an important tactic in HIV prevention among youth, resulting in fewer years at high risk. “Abstinence-only” programs, which promote complete sexual abstinence as the only effective method for preventing unintended pregnancy and sexually transmitted infections including HIV, have not been demonstrated to reduce HIV risk behaviors. Recommended instead are comprehensive sexual education programs that include sex education and information on abstinence, delay of sexual debut, partner limitation, condom use, and contraception lay sexual debut.
Exposure prophylaxis or early treatment of infection.
Pre-exposure prophylaxis, or PrEP, is a way for people who do not have HIV but who are at substantial risk of getting it to prevent HIV infection by taking a pill every day. The pill (brand name Truvada) contains two medicines (tenofovir and emtricitabine) that are used in combination with other medicines to treat HIV. When someone is exposed to HIV through sex or injection drug use, these medicines can work to keep the virus from establishing a permanent infection.When taken consistently, PrEP has been shown to reduce the risk of HIV infection in people who are at high risk by up to 92%. PrEP is much less effective if it is not taken consistently.PrEP is a powerful HIV prevention tool and can be combined with condoms and other prevention methods to provide even greater protection than when used alone. But people who use PrEP must commit to taking the drug every day and seeing their health care provider for follow-up every 3 months. PEP should be used only in emergency situations and must be started within 72 hours after a recent possible exposure to HIV. It is not a substitute for regular use of other proven HIV prevention methods, such as pre-exposure prophylaxis (PrEP), which means taking HIV medicines daily to lower your chance of getting infected; using condoms the right way every time you have sex; and using only your own new, sterile needles and works every time you inject.PEP is effective, but not 100%, so you should continue to use condoms with sex partners and safe injection practices while taking PEP. These strategies can protect you from being exposed to HIV again and reduce the chances of transmitting HIV to others if you do become infected while you’re on PEP.
Female controlled microbicides (approach to prevention of HIV and AIDs)
Microbicides are products applied inside the vagina or rectum to protect against HIV though sex. Although microbicides are not yet available for widespread use, researchers are making significant strides in the development and clinical evaluation of both vaginal and rectal microbicide products. Microbicides that incorporate antiretroviral (ARV) drugs are showing particular promise.Human immunodeficiency virus (HIV), causative agent of acquired immunodeficiency syndrome (AIDS), is a global health concern. To control its transmission, safe sex has been proposed as one of the strategies. Microbicides- intravaginal/intrarectal topical formulations of anti-HIV agents have also been proposed to prevent HIV transmission. Microbicides would provide protection by directly inactivating HIV or preventing the attachment, entry or replication of HIV in susceptible target cells as well as their dissemination from target cells present in semen or the host cells lining the vaginal/rectal wall to other migratory cells. Microbicides must be safe, effective following vaginal or rectal administration, and should cause minimal or no genital symptoms or inflammations following long-term repeated usage. However, a safe and efficacious anti-HIV microbicide is not yet available despite the fact that more than 60 candidate agents have been identified to have in vitroactivity against HIV, several of which have advanced to clinical testing. Nonetheless, proof-of-concept of microbicides has been established based on the results of recent CAPRISA 004 clinical trials. In this article, the trends and challenges in the development of effective and safe microbicides to combat HIV transmission are reviewed
Get tested and know your partner status
Getting tested is the most important thing you can do for yourself and for others in the fight against HIV/AIDS. Knowing your status empowers you to make informed decisions. People are more likely to use caution if they know they can spread the virus. If you are negative, you can learn how to stay negative. If you are positive, you can seek treatment to live a long and healthy life. The only way to know for sure whether you have HIV is to get tested. CDC recommends HIV Testing for everyone between the ages of 13 and 64 at least once as part of routine health care. Knowing your HIV status gives you powerful information to help you take steps to keep you and your partner healthy. This section answers some of the most common questions related to HIV testing, including the types of tests available, where to get one, and what to expect when you get tested. As a part of the world-renowned AIDS Healthcare Foundation, AHF Healthcare Centers offer the most accurate HIV Testing procedures and the most advanced therapies available. We are committed to delivering personalized, leading-edge care to patients with HIV/AIDS or other immunological deficiencies.


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